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Choosing a VBAC

People who had a prior Cesarean birth deserve safe, personalized and evidence-based care when deciding the best path in a new pregnancy. At Oula, we’re committed to providing you with non-judgmental education about the differences between choosing a VBAC (“Vaginal Birth After Cesarean”) or a planned repeat Cesarean birth. People often choose us for their pregnancy care because they are seeking a supportive environment for VBAC and we are excited to be a leader in this space. 

The decision to choose VBAC begins with a careful review of your obstetrical history with a clinician. Some of the factors that impact the safety of a VBAC include the type of surgical incision, number of previous cesarean births, and reason for surgery.

Benefits of VBAC

When making a decision about the best path for this birth, it’s always a good idea to consider the risks and benefits of both options. There are many benefits in choosing VBAC, including no need for abdominal surgery, shorter recovery period, lower risk of infection, and less blood loss. Also, if you plan to have future pregnancies, having a successful VBAC can minimize risks of placental abnormalities and other surgical complications. National research shows that 60-80% of attempted VBACs will be successful.

Risks of VBAC

The risks of VBAC include all general risks of vaginal birth as well as the rare but serious risk of uterine rupture (a re-opening of the uterine scar) which is dangerous for you and the baby. For someone who meets all the criteria for a VBAC (determined with your care team), the risk of uterine rupture is < 1%. Your care provider would discuss if you have any factors that could increase this risk. There is also the possibility that the attempt to VBAC will not be successful and you would make the collaborative decision to proceed with a repeat cesarean birth.

Some things to keep in mind

  • You can expect to have continuous monitoring to assess how your baby is tolerating labor, as well as an IV placed when you get admitted to the hospital.
  • If our team recommends an induction of labor at the end of your pregnancy, there are some medications that are not safe for VBAC. We will review the personalized medical plan with you in detail at your appointments, as well as before administering any medication on the labor floor.
  • Our full medical team will be available 24/7, including an anesthesiologist and surgeon in the event of a change of plans 
  • Regardless of what happens, an Oula midwife will stick with you every step of the way.

At Oula, all of our patients considering VBAC will meet with an Oula OB/GYN physician at 36 weeks of pregnancy to review your pregnancy and discuss the risks and benefits, specific to your preference and circumstances, of choosing this care plan. If you decide to pursue VBAC, or to schedule a planned repeat cesarean birth at that time, we are there to provide non-judgmental support and empower you in your decision and care.